MR. MATTHEW BENJAMIN BUSTILLOS (NPI# 1578605010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578605010 |
| Entity Type | Individual |
| Full Name | MR. MATTHEW BENJAMIN BUSTILLOS |
| Credential | P.T. |
| Practice Address |
24731 Alicia Pkwy Unit B Laguna Hills CA 92653-4653 |
| Mailing Address |
27222 Nogal Mission Viejo CA 92692-3422 |
| Practice Telephone | 9495887278 |
| Practice Fax Number | 9495887331 |
| Mailing Telephone | 9493671598 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2014-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
PT15153 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
24731 ALICIA PKWY UNIT B |
| City | LAGUNA HILLS |
| State | CA |
| Zip Code | 92653-4653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346383858 | Christy Sue Costeniero | Physical Therapist | 24731 Alicia Pkwy, Unit B, Laguna Hills, CA 92653-4653 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932708476 | Nikkie Veyseh | Behavior Technician | 26921 Falling Leaf Dr., Laguna Hills, CA 92653 | 2020-10-24 |
| 1609480425 | Steve Ceja | Behavior Technician | 25201 Paseo De Alicia Suite 110, Laguna Hills, CA 92653 | 2020-08-31 |
| 1467006882 | Kristina Alexa Puno Morales | Dietitian, Registered | 24552 Health Center Drive, Laguna Hills, CA 92653 | 2019-07-25 |
| 1164929626 | Shoreline Consulting Services, Inc. | Clinic/Center | 23010 Lake Forest Drive, Suite B, Laguna Hills, CA 92653 | 2018-04-11 |
| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1831613850 | Stephani A Berg | Physical Medicine & Rehabilitation | 24422 Avenida De La Carlota Suite 190, Laguna Hills, CA 92653 | 2017-08-01 |
| 1497299945 | Stephanie Lyle | Nurse Practitioner | 24221 Calle De Louisa, Suite 400, Laguna Hills, CA 92653 | 2016-12-16 |
| 1053776278 | Meillanny Gladness | Counselor | 23151 Verdugo Dr Ste 203, Laguna Hills, CA 92653 | 2015-12-16 |
| 1912383183 | Pmdca, LLC | Clinical Medical Laboratory | 23297 S Pointe Dr Ste 100, Laguna Hills, CA 92653 | 2015-08-10 |
| 1821486630 | 4mpw, Inc. | Home Health | 23232 Peralta Drive 216, Laguan Hills, CA 92653 | 2014-12-31 |
| Find all providers in zip 92653 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861608317 | Nicholas Steven Nosek | Physical Therapist | 26941 Cabot Rd, Suite 125, Laguna Hills, CA 92653-7030 | 2007-05-14 |
| 1568596237 | Beatrice Gazda Blewett | Physical Therapist | 23271 Verdugo Dr, Suite B, Laguna Hills, CA 92653-1347 | 2007-03-15 |
| 1255949467 | Phillip Carr | Physical Therapist | 23961 Calle De La Magdalena, Laguna Hills, CA 92653-3616 | 2020-07-14 |
| 1053957241 | Ryan Guzman | Physical Therapist | 23001 Del Lago Dr, Laguna Hills, CA 92653-1354 | 2019-11-22 |
| 1417340258 | Christopher David | Physical Therapist | 22995 Mill Creek Dr, Suite A, Laguna Hills, CA 92653-1215 | 2015-03-17 |
| 1962747568 | David Thomas Hayes | Physical Therapist | 22995 Mill Creek Dr, Suite A, Laguna Hills, CA 92653-1215 | 2012-12-07 |
| 1902127772 | Nosek Physical Therapy Inc | Physical Therapist | 26941 Cabot Rd, Suite 124, Laguna Hills, CA 92653-7030 | 2010-06-16 |
| 1134356447 | Marco Artiano | Physical Therapist | 23961 Calle De La Magdalena, Suite 400, Laguna Hills, CA 92653-3616 | 2009-06-12 |
| 1104062348 | Ryan Andrew Friend | Physical Therapist | 26941 Cabot Rd, Suite 125, Laguna Hills, CA 92653-7030 | 2008-12-17 |
| 1487829933 | Paul Robert Addison Jr. | Physical Therapist | 26941 Cabot Rd, #103, Laguna Hills, CA 92653-7030 | 2008-04-25 |
| Find all providers in LAGUNA HILLS | ||||
| City | LAGUNA HILLS |
| Zip Code | 92653 |
Please comment or provide details below to improve the information on MR. MATTHEW BENJAMIN BUSTILLOS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.